EXPERT REACTION: The Indian B1617 COVID-19 variant is in the Melbourne community

The B.1.617 variant, first identified in India, is possibly 50 per cent more transmissible than other variants of concern. It was only a matter of time before an outbreak like this occurred, and we will continue to see virus incursions like this despite our best efforts. 

Vaccines will still be effective against the B.1.617 variant. A recent study from Public Health England shows that two doses of the vaccines are highly effective. 

We’ve been lucky in Australia; we have kept the virus at bay, but we have also become complacent. This latest virus incursion in Melbourne is a sober reminder that anyone who is eligible for vaccination should go out and get their shot. The more people who are vaccinated and immune, the more we’ll be able to protect those most vulnerable in our communities — our parents and grandparents, friends and loved ones. 

In the meantime, we need to continue practising good hand hygiene and social distancing. Where mandated or where it is impossible to keep a safe social distance, masks should be worn.

This reinforces several things we already know about this virus.

1. It is highly infectious amongst adults
2. Due to our success with public health protections, our population remains very vulnerable.
3. Until we reach herd immunity in Australia, we will remain vulnerable and at risk from re-entry of the virus into the country through returning travellers. If this disease breaks out as it did in the US and throughout Europe, then we can expect more than 50,000 people to die.
4. Our only safe hope to obtain herd immunity is through vaccination.
5. While there are some rare side effects to the current vaccines, the risk of the diseases far outweigh the risks of the vaccine.

It would be important to know if it is B.1617.1 or B.1617.2. Earlier media reports indicated the person from Wollert was infected with  B.1617.1. Based on reports from India, this variant may have atypical clinical presentations, such as abdominal pain, nausea, vomiting, diarrhea and hearing impairments, as well as an absence of fever.  If this is the case, people should be on the alert for any of these symptoms as well as more typical COVID symptoms such as cough and fever. 

If it is B.1617.2, this would be more concerning, as preliminary reports from the UK, where B.1617.2 is surging in some parts of the country, suggest it is 50 per cent more contagious than the UK variant B117, which is already 50-100 per cent more contagious than the “regular” strain. 

This means it will be much more difficult to control. Reports from the UK also show that the effectiveness of one dose of Pfizer or AstraZeneca is only 33 per cent against B.1617.2; but this rises to 88 per cent after two doses for Pfizer and 59.8 per cent after two doses of AstraZeneca. This means it does have some resistance to vaccines, although not as much as the South African variant.  There is also the possibility of evasion from vaccines for the B.1617.1.  These are reasons why people should get vaccinated as soon as possible, and why a three month gap to wait for your second dose may end up being costly during an epidemic, as I explained yesterday in The Conversation.

The SARS CoV-2 B 1.617.2 variant is one of a number of “variants of concern”. This one in particular has been responsible for the recent terrible surges of COVID-19 in India, and has broken through to other countries via air travel, notably now in the UK, that have previously been successful in lowering cases. This variant is considered to be more infectious than previous SAR CoV-2’s, including the “UK” B 1.1.7 variant. So this is a cause for concern, as outbreaks can move quickly and relatively silently though local communities until a major incident occurs. There is no room for complacency. There is also a certain inevitability to this, because as the virus evolves, its biological properties (infectivity, infection window and incubation time) can change as well (there is not enough information on this).

That means that modifications to testing protocols and biosecurity measures might be required to adapt to the new biology of the virus. Thus a dynamic and agile response to monitoring the viral strain threats is required to inform the healthcare policy around quarantine procedures. Put simply, what has worked very well for Australia so far, and we have been remarkably spared from disease to date, might not work so well in future.

Thus, biosecurity policy needs informing by dynamic scientific intelligence in real time, and that intelligence needs regular review and if necessary decisive action. Although the new variant might be more infectious there is now significant evidence that all the major vaccines blunt the severity of all the variants we have seen so far. If Australia is to unlock its international gateways again safely in a meaningful way (which is ultimately essential for the economy), then the majority of the population need to get vaccinated as soon as possible and the government needs to act just as decisively as it has done for lockdowns (applause) as it needs to do for the largescale vaccine roll-out (less applause).

The news of community transmission involving the Indian variant reinforces that the freedoms we have right now in Victoria and in Australia are built on precarious foundations, and things could change at any time.  As has always been the case we can look internationally for examples of what we want to avoid - instances where complacency crept in and the virus took advantage.
 
This is a timely reminder that we need to keep doing the basics until we get the population vaccinated. Get tested if you have any cold like symptoms, check in to venues using QR codes, wear masks where appropriate and disinfect your hands regularly. Whether we keep up with these precautions could be the difference between avoiding another lockdown or not.

With now five cases it is clear that there is COVID in the community that is only now surfacing. Todays changes in government social distancing requirements are appropriate and demonstrate the clear need to be vigilant. However, we can be comforted that we are ahead of the game in regards to contact tracing and appropriate management of outbreaks.

It also highlights the clear need for everyone to get vaccinated as soon as possible, irrespective of which vaccine is being offered. Having a vaccinated population will fundamentally change how we live alongside this virus.